HAILEY D WALLACE (CRNA) – Certified Registered Nurse Anesthetist, NPI 1104305432
Certified Registered Nurse Anesthetist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for HAILEY D WALLACE (CRNA)
750, Cross Pointe Road, Gahanna, Mifflin Township, Ohio, 43230, United States
GAHANNA, OH 432306692
Phone: (614) 761-1255
Fax: (614) 552-0168
Type: Mailing
The Ohio Surgery Center, 930, Bethel Road, Columbus, Perry Township, Franklin, Ohio, 43214, United States
COLUMBUS, OH 432141906
Phone: (614) 451-0500
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-08-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180822002245 | I | Certified Registered Nurse Anesthetist (Crna) | OH | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 00160 | Anesthesia for other procedure on nose and sinuses | 17 | 17 | $0 |
Insurance plans in this area (ZIP 43230)
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